Prevention of Kidney Stones

Once you've had a kidney stone, you face recurrence rates of 50 percent over five years. Prevention methods can be an important tool in stone disease management. For this reason, the Comprehensive Kidney Stone Center focuses not only on the treatment, but on the aggressive prevention of initial and recurring stones.

Prevention is Possible

Under the direction of Dr. Roger Sur, a leader in the field of innovative kidney stone evaluation prevention, we can create a successful prevention plan in almost 90 percent of our patients. Our program is able to detect an impressive 97 percent of underlying medical abnormalities in stone forming patients.

Using this information, we can provide general recommendations as well as effective, highly individualized therapies to prevent stone recurrence.

Specialized Prevention

Individual conditions and risk factors that we address include:

Hypercalciuria

In this condition, excess reabsorption of calcium through the bowels will lead to excess calcium in the body. This excess calcium spills over into the kidneys, which excretes this calcium into the urine, and calcium stones subsequently form.

Type I Hypercalciuria is not affected by how much calcium a person consumes in the diet. The excess reabsorption is independent of dietary calcium. Restricting dietary calcium will not decrease the risk of stone formation in this particular condition.

Type II Hypercalciuria is affected by calcium consumption in the diet. Therefore, calcium restriction leads to decreased risk of stone formation. Common sources of calcium include dairy products, such as milk, yogurt, ice cream, cheese, and orange juice (which is often supplemented by calcium). Moderate restriction in diary products is recommended for this condition.

Gouty Diathesis

This is a condition of overly acidic urine in which the urinary pH is lower than usual. Our specialists can use conservative methods and medications to normalize this abnormality.

Hypocitraturia

Urinary citrate is a natural inhibitor of kidney stone formation. Some people have lower than usual urinary citrate levels, and thus have higher risk of stone formation. We use medications and dietary methods to alter this abnormality and decrease risk of kidney stone formation.

Cystinuria

This genetic condition involves abnormal transport of amino acids and subsequent excess secretion of cystine into the urine. Patients with this condition often develop cystine kidney stones at a young age and have an extremely high rate of recurrent kidney stones throughout there lifetime. Medical therapy and dietary modifications can decrease the risk of recurrent kidney stones in these patients.

Struvite or Infection Stones

In this condition, specific types of bacteria produce an enzyme that leads to excess production of urea metabolites (ammonium). Magnesium ammonium phosphate stones, also known as struvite or staghorn kidney stones, subsequently form.

Hyperoxaluria

Primary hyperoxaluria is a rare congenital defect that leads to profoundly elevated levels of oxalate. Dietary oxaluria is a more common form of hyperoxaluria and is associated with excess dietary oxalate. Foods abundant in oxalate include chocolate, nuts, dark leafy green vegetables, coffee, tea, and vitamin C. In the latter case, a restricted diet can help in preventing stone formation.

Hyperuricosuria

In this condition, excess uric acid levels can lead to stone formation. Treatment involves medications such as Allopurinol.